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Systemic treatment and radiotherapy 

Systemic treatment and radiotherapy
Chapter:
Systemic treatment and radiotherapy
Author(s):

Rajesh Jena

, and Peter Harper

DOI:
10.1093/med/9780198746690.003.0050
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date: 07 March 2021

Cancer therapy is underpinned by a detailed understanding of cancer biology and the complex interaction of tumour and host. Systemic therapies and radiation therapy are being used in many early stage cancers, with a ‘risk adaptive’ approach to maximize the likelihood of uncomplicated tumour cure, both as primary treatment and in the postoperative setting. Targeted therapies have changed the course of many common cancers. Patients with early stage disease benefit through enhanced cure rates, while rational treatment approaches to metastatic disease improve outlook for many patients. Where cancer therapies are given with curative intent, care must be taken to consider long-term toxicities. Systemic therapies may be associated with organ-specific late effects such as dose-dependent cardiac toxicity from anthracycline chemotherapy, lung fibrosis from bleomycin, and sensorineural hearing loss from vincristine. Radiation therapy also carries a risk of tissue damage, dependent on the dose and volume of tissue that is irradiated.

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